Video laryngoscope with detachable light and image guides

ABSTRACT

A combination laryngoscope and video display for providing images of the area ahead of the laryngoscope to facilitate insertion without damaging the surrounding tissue; the laryngoscope having a detachable blade and a rigid, detachable light and image guide attachment device for providing illuminating light ahead of the blade and for detecting the reflected light.

FIELD OF THE INVENTION

[0001] The invention relates to an intubating video laryngoscope with arigid, detachably connectable light guiding system and video guidingsystem.

BACKGROUND OF THE INVENTION

[0002] In the United States, approximately 10 million patients areoperated on and anesthetized each year. While anesthetized, thepatient's breathing functions are temporarily disabled. Ventilation istherefore supplied to the patient by the anesthesiologist during theprocedure.

[0003] Ventilation is provided through an endotracheal tube. This tubeis inserted into the trachea, and it is closed against the wall of thetrachea by an inflatable cuff. The insertion of this tube involves risksthat the anesthesiologist seeks to avoid or at least minimize. It isestimated that between one in 6,000 to one in 8,000 general anesthesiaprocedures result in death. There are of course many causes but of theseit is estimated that about one third of them are caused by theintubation procedure.

[0004] The foremost obstacles encountered by the anesthesiologistinclude; the remoteness of the location where the tube is to bepositioned, the consequent restriction of view as the tube is inserted,variations and anomalies in the anatomy of the patients, anuncomfortable and unnatural position for the anesthesiologist whileholding the instrument, the potential need to change blades during theprocedure, and the necessity for rapid intubation.

[0005] It should be noted that when the tube is inserted, the patient isasleep hyperoxygenated and then paralyzed for the procedure, andtherefore not breathing. In addition, the ventilator is not yet inoperation. This gives the anesthesiologist only about two minutes inwhich to intubate the patient, inflate the cuff, and start ventilation.If he is delayed because of unsuccessful attempts, he must stop, apply aventilation mask to the patient, supply oxygen for a time through themask, remove the mask, adjust medication if necessary, and then startover again. This delays the operation and extends the patient's timeunder anesthesia. This extension of time while under anesthesia may havevery serious consequences, especially for elderly patients.

[0006] With the advent of endoscopic equipment and small cameras,instrumentation has been improved to the extent that it can enableviewing of the cords and larynx on a video screen thereby facilitatingthe intubation of the patient in a relatively quick and safe manner.However, conventional instrumentation may be further improved such thatthe laryngoscope is easier to use, thereby reducing the time involvedfor instance, to change blades or attach and detach peripheralcomponents.

[0007] Endoscopes are now widely used in minimally invasive surgery.Endoscopes typically contain a light guiding system, usually in the formof fiber optic cables, in order to bring light to the surgical area. Thelight guiding system typically extends through the handle of thelaryngoscope and through a guide tube located in the blade so as toposition the light guiding system to illuminate the area ahead of theblade. Endoscopes also typically contain an image guiding system, forexample in the form of a rigid rod lens system, arranged in the shaft ofthe endoscope. The image guiding system can also be configured as anordered, flexible fiber optic bundle. The image guiding system isutilized to transmit reflected light from the area ahead of the blade toa camera. The camera, attached at the proximal end of the endoscope,usually contains a CCD (charge coupled device) sensor, in the form of alight-sensitive chip that converts the optical signals into electricalsignals that are conveyed from the image-sensing camera module to aremotely located image processing system. The image guide typicallyextends from the distal end of the blade through the guide tube and thenthrough the handle of the laryngoscope.

[0008] Typically, the combination light guiding system and image guidingsystem are permanently attached to the handle and are continuous,extending from the distal end of the blade, through the handle of thelaryngoscope and to the camera for the image guiding system, and to thelight source for the light guiding system. Therefore, the light guidingsystem and image guiding system extending from the handle of thelaryngoscope for insertion into the guide tube of the blade typicallycomprise flexible coherent fiber optic bundles. However, when changingblades, the bundle must be carefully inserted or withdrawn from theopening of the guide tube at the proximal end of the blade. This maytake an unacceptable amount time for the physician to thread the bundleinto the tube if the blade must be changed in the middle of theintubation process.

[0009] The light and image guiding systems have typically beenpermanently attached to the handle to ensure the system will reliablytransmit the illuminating light and reflected images. To utilize adetachably connectable light and image guiding system, the attachmentmeans would have to rigidly hold the member in place such that the lightand image guiding systems did not become misaligned. In addition, theattachment means must be easy and quick to operate, making it possibleto perform the coupling procedure with as little close attention aspossible, but nevertheless reliably. Provision must therefore be madefor the coupling elements to be keyed to each other so that the couplingcannot be incorrectly joined and so that close attention by theoperation is not required.

[0010] In addition, the flexible bundles may easily be damaged and willwear over time, degrading or rendering the system inoperable. As avisual inspection of the device often will not indicate whether thebundles are damaged, it is conceivable that a physician may obtain adamaged or malfunctioning laryngoscope not realizing that it is damaged.The time involved with determining that the instrument ismalfunctioning, withdrawing it, finding another laryngoscope, and thenintubating the patient may have severe adverse effects upon the patientunder anesthesia.

[0011] Further, laryngoscopes, as with most medical equipment, must besterilized after use. Because the light and image guiding systems arepermanently attached to the handle, they are exposed to extremely hightemperatures, which also cause wear and/or failure of the flexiblebundles. Also, because the light and image guiding systems are subjectedto the sterilization process with the handle and blades, the handle mustbe hermetically sealed which may greatly add to the cost inmanufacturing such a device.

[0012] It is therefore desired to provide an improved video laryngoscopethat is easy to use and will facilitate the quick removal andreattachment of a blade, the light guiding system and the image guidingsystem.

[0013] It is also desired to provide an improved video laryngoscope witha highly durable light guiding system and image guiding system.

[0014] It is further desired to provide an improved video laryngoscopethat will reduce the costs associated with the manufacture of thelaryngoscope.

[0015] It is also desired to provide an improved video laryngoscopehaving a coupling system that will reliably connect the laryngoscopehandle with a light and image guiding attachment while requiring aminimal amount of attention from the user to attach or detach.

SUMMARY OF THE INVENTION

[0016] These and other objectives are achieved by providing a videolaryngoscope having a coupling mechanism that rigidly connects thelaryngoscope handle to the light and image guiding attachment.

[0017] Accordingly, the coupling mechanism is provided with a firstcylindrical stem of specific diameter and specific length, in whoseinterior is received a proximal end segment of the light guiding system,and which projects from one coupling end of the light and image guidingattachment in the coupling direction. Further, a second cylindrical stemis provided whose length and diameter are greater than the length anddiameter of the first stem, having a proximal end segment of the imageguiding system being received in the interior of the second stem, andwhich projects from one coupling end of the light and image guidingattachment in the coupling direction. The second stem coacts with aninterlock system arranged in the laryngoscope handle forming a rigidmechanical coupling, the first and second stems extending at a distancenext to one another. Complementary receptacles corresponding to the twostems, into which the stems penetrate, are provided in the laryngoscopehandle. The base of the receptacle into which the second stem penetratesis optically connected to the camera, and the receptacle in which theshorter first stem is receivable is connected to the light source.

[0018] The mechanical, light-guiding, and image-guiding coupling isaccomplished by way of a single simple linear displacement operation, inwhich specifically the two stems are pushed into the correspondingreceptacles of the laryngoscope handle. Because one of the two stems isthicker and longer than the other, incorrect (i.e. reversed) insertionis not possible. Because the thicker stem is also simultaneously thelonger one, it is possible, without undue attention, to feel for thecorrespondingly larger receptacle on the camera module with this thickerand longer stem, and then to close the coupling with an insertionmovement. Incorrect attachment is thus no longer possible, since thethicker and longer stem cannot be attached to the smaller-diameterreceptacle for the smaller and shorter stem.

[0019] The mechanical interlock or coupling is affected simultaneouslywith this insertion. Because the larger stem is also the longer stem,and it carries the image guiding system, the image-guiding connectionoccurs at an axial spacing from the light-guiding connection. Thisfeature has the advantage that any stray light that might emerge fromthe light connection cannot directly come into contact with theimage-guiding connecting point located at an axial distance therefrom.The disadvantages of connecting image and light at the same level, orthose, for example, of a coaxial arrangement, are thus eliminated.

[0020] Because the coupling mechanism is keyed, the physician cantherefore, for example, sense the laryngoscope handle and its precisegrasped position in the coupling region with one hand, and with theother hand can easily sense the light and image guiding attachment andits grasped position as well, so that the two elements to be coupled canthen be inserted into one another without visual contact. This greatlyfacilitates handling, especially when, during a procedure, one bladeneeds to be quickly exchanged for another, such that the light and imageguiding attachment must be removed and re-attached along with the blade.

[0021] An interlock system is displaceable transversely to the couplingdirection that can be engaged into a recess on the second stem. Thisfeature has the advantage that in order to close and/or release thecoupling, the locking element is displaced transversely to the couplingdirection and is engaged into or disengaged from the recess on thesecond stem. These are all procedures that can be controlled, withoutvisual contact, with the fingers of one hand; the snapping of thelocking element into and out of the recess on the stem indicates to theoperator whether the coupling is closed or open. If the locking elementneeds to be pushed into the recess, for example to close the coupling,this can be done by simply inserting the stems into their correspondingreceptacles; precise locking can be ascertained by an audible sound thatthe locking element has been engaged. The locking element may comprisefor instance, ball catches, hooks, snap lugs, or the like.

[0022] The locking element is acted upon by the force of a spring, andradially projects into the receptacle for the second stem. This isadvantageous because, the force of the spring presses the lockingelement into a defined position, and the coupling may be disengaged bythe application of a force opposite the coupling direction, namelywithdrawing the stems from their respective receptacles. These are allprocedures that can be sensed and controlled with the hand's sense oftouch, so that no visual attention or observation is necessary whenclosing and opening the coupling.

[0023] The second stem may have a conical segment at the end that isfollowed by an undercut. The conical segment constitutes an insertionaid upon insertion of the stem into the receptacle, so that exactinsertion is guaranteed with even approximate placement. At the sametime, the conical surface can be utilized to displace the lockingelement radially upon insertion.

[0024] In addition, the undercut in the second stem may be configured asan annular groove. This forms a relatively large engagement surface withthe locking element, so that the mechanical forces acting on thecoupling will be dispersed over the entire area, which contributes tomechanical stability and less wear through use.

[0025] In addition, the first and second stems along with thereceptacles receiving them each have a window. The windows therebyprovide a sealed closure for the light and image guiding systems.

[0026] The light and image guiding attachment is preferably providedwith a stainless steel outer casing, or some other suitable rigidenclosure, for protecting the light and image guides. As the light andimage guiding attachment is detachable from the handle, the handle doesnot have to be hermetically sealed for sterilization. Rather, only thelight and image guiding attachment need be subjected to sterilization.

[0027] Accordingly, in one advantageous embodiment of the presentinvention, an intubating laryngoscope system is provided comprising ablade, a handle and a joinder for detachably connecting the handle tothe blade. The system also includes a two-stem receptacle connector, afirst light guide for transmitting illuminating light that is terminatedin the two-stem receptacle connector, an first image guide fortransmitting reflected light that is also terminated in the two-stemreceptacle connector, and a light and image guiding attachment,detachably connectable to the handle. The light and image guidingattachment includes a two-stem plug connector designed to mate with thetwo-stem receptacle connector, a second light guide for transmittingilluminating light and terminated in the two-stem plug connector, asecond image guide for transmitting reflected light and terminated inthe two-stem plug connector, and a substantially rigid outer casing forencasing the second light guide and the second image guide.

[0028] In another advantageous embodiment of the present invention, anintubating laryngoscope system is provided comprising a handle havingfirst light guide and a first image guide, a blade, a joinder fordetachably connecting the handle to the blade, and a receptacleconnector for terminating the first light guide and the first imageguide. The system further includes a light and image guiding attachmentthat is detachably connectable to the handle and has a plug connectorwith a first stem and a second stem, a second light guide terminated inthe first stem, a second image guide terminated in the second stem, anda substantially rigid outer casing for encasing the second light guideand the second image guide.

[0029] In yet another advantageous embodiment of the present invention,a method for providing an intubating laryngoscope system is disclosedincluding the steps of providing a handle having a first light guide anda first image guide, providing a blade, providing a receptacle connectorlocated in the handle, terminating the first light guide and the firstimage guide in the receptacle connector, and providing a rigid light andimage attachment that is detachably connectable to the handle. The lightand image attachment have a second light guide and a second image guidelocated therein and provide a plug connector at a proximal end of thelight and image attachment. The method further includes terminating thesecond light guide in the plug connector, terminating the second imageguide in the plug connector, detachably connecting the blade to thehandle, and detachably connecting the light and image attachment to thehandle such that the light and image attachment is rigidly attached tothe handle when in an engaged position.

[0030] In still another advantageous embodiment of the presentinvention, an intubating laryngoscope system is provided comprising ahandle having a first light guide and a second image guide, a bladeconnected to the handle, a receptacle connector for terminating thefirst light guide and the first image guide, and a substantially rigidlight and image guiding attachment. The rigid light and image guidingattachment is detachably connectable to the handle, and has a plugconnector receivable in the receptacle connector, a second light guideterminated in the plug connector, and a second image guide terminated inthe plug connector. In addition, the first light guide and the firstimage guide are in communication with the second light guide and thesecond image guide respectively, via the receptacle and plug connectors.

[0031] It is understood that the features mentioned above and those yetto be explained below can be used not only in the respectivecombinations indicted, but also in other combinations or by themselves,without leaving the context of the present invention.

BRIEF DESCRIPTION OF THE DRAWINGS

[0032]FIG. 1 is an illustration of the video laryngoscope with a curvedblade and the light and image guiding attachment engaged with thehandle.

[0033]FIG. 2 is an illustration of a curved blade detached from thehandle.

[0034]FIG. 3 is a perspective view of the handle depicting the housingcontaining the receptacles for the light and image guiding attachment.

[0035]FIG. 4 is an illustration of the curved light and image guidingattachment as detached from the handle.

[0036]FIG. 5 is a cross-sectional view of the housing containing thereceptacles for the light and image guiding attachment.

[0037]FIG. 6 is a cross-sectional view of the coupling element utilizedin conjunction with the light and image guiding attachment.

[0038]FIG. 7 is an illustration of the video laryngoscope with astraight blade and the light and image guiding attachment engaged withthe handle.

DETAILED DESCRIPTION OF THE DRAWINGS

[0039] The video laryngoscope 10, along with the attached blade 12 andlight and image guiding attachment 14 is illustrated in FIG. 1. Thevideo laryngoscope 10 is comprised of three main parts; the blade 12,the light and image guiding attachment 14, and the handle 16.

[0040] The handle 16 is typically cylindrical with a knurled outersurface 18 thereby facilitating a secure gripping surface. As is shownin FIG. 1, the handle 16 is detachably joined to a blade 12, which inthis instance is curved, by a hinge-type joinder 20.

[0041] The hinge-type joinder 20 includes a pair of conventional hingesocket 22 and connector 24 respectively mounted to the lower end of thehandle 16 and to a proximal end 34 of the blade 12. Socket 22 furtherincludes a crossbar 26. Connector 24 includes a hook 28 in a block 30that fits into socket 22 and is more clearly seen in FIG. 2. The hook 28engages the crossbar 26, and the handle 16 is rotated 90 degrees so thatthe blade will be rigidly held to the handle 16. This is a commonhinge-type joinder 20 used in this type of instrumentation and is usefulfor all blade forms, of which the two illustrated forms are merelyexamples. A ball detent 32 detachably retains the handle 16 and blade 12together and erect in the assembled configuration. The assembledinstrument is rigid during the procedure.

[0042] Blade 12 has a distal end 36 which may be smoothed by a bulb-likeedge 38. It has a curved top surface 40 extending from the distal end 38toward the proximal end 34. This top surface 40 is used to elevate thetongue and permit the visualization of the vocal cords beneath it.

[0043] Referring back to FIGS. 1 and 2, blade 12 additionally includesan attachment hole 42 at the distal end 36 of the blade 12. Theattachment hole 42 is designed to receive a distal end 43 of light andimage guiding attachment 14 so and to provide additional support torigidly hold it in position and align the distal end 43 of the light andimage guiding attachment 14 with the distal end 36 of the blade 12.

[0044] The handle is provided with means for obtaining an image of thefield located beyond the tip of the blade 12, and for providingilluminating light to that field. In one embodiment, a camera (notshown) is mounted in a chamber inside the handle 16.

[0045] An image cable 44 to conduct image data from the camera exitsfrom the top of the handle 16. It is connected to a video set (notshown), which provides data for an image on a video screen (not shown),for observation by the anesthesiologist. In addition, in someembodiments an illumination cable 46 conducts illuminating light to thehandle 16.

[0046] In one embodiment, light for illumination of the field ahead ofthe distal end 36 of blade 12 is obtained from a separate light source(not shown) that can be placed in any convenient nearby location. Anillumination cable 46, which may comprise a fiber optic bundle extendsfrom the light source (not shown) to the handle 16. The illuminationcable 46 need not be coherent, because it does not transmit an image—ittransmits only illuminating light. Both the image cable 44 and theillumination cable 46 may enter the top of handle 16.

[0047] The actual construction of image cable 44 depends on thearrangement of the camera. In a preferred embodiment, the camera (notshown), customarily a CCD chip, is mounted in the handle 16. In thiscase, the image cable 44 comprises a electrical cable, which extendsfrom the camera output (not shown), out the top of the handle and to avideo display (not shown). The image guide extending through the lightand image guiding attachment 14, through the handle 16 and terminatingat the camera input (not shown) comprises a bundle of coherent fiberoptic cables to transmit the reflected light from the area ahead of theblade 12 to the camera (not shown).

[0048] In an alternative embodiment, the camera (not shown) may belocated remotely from the video laryngoscope 10. In this case, the imageguiding cable 44 would comprise a bundle of coherent fiber optic cablesextending through the light and image guiding attachment 14, through thehandle 16 and terminating at the camera, which is located remotely fromthe video laryngoscope 10.

[0049] The light guiding system receptacle 52 and the image guidingsystem receptacle 48 are both contained in housing 50 as illustrated inFIGS. 3 and 5. The light guiding system receptacle 52 has an innersurface 54 defining a cross-sectional diameter of the receptacle openingcorresponding to a diameter of a first stem 56 shown in FIGS. 4, 5 and6. Further, the image guiding system receptacle 48 has an inner surface58 defining a cross-sectional diameter of the receptacle openingcorresponding to a diameter of a second stem 60 also shown in FIGS. 4, 5and 6.

[0050]FIG. 4 shows the light and image guiding attachment 14 detachedfrom the handle 16. The light and image guiding attachment 14 comprisesa rigid curved shaft 62 and a coupling element 64. The coupling element64 further comprises a first stem 56 and a second stem 60 along with ahousing 66. The rigid curved shaft 62 is preferably made of stainlesssteel but may be manufactured on any rigid non-corroding material. Therigid curved shaft contains both, the light guiding cable 46 fortransmitting illuminating light ahead of the distal end 36 of the blade12, and the image guiding cable 44 for receiving the reflected light andtransmitting it to the camera (not shown) located in the handle 16. Therigid curved shaft 62 also has a window 66, located at the distal end68, which acts to seal the light and image guiding attachment 14.

[0051] Referring back to the coupling element 64, an approximatelycylindrical second stem 60, protrudes at one coupling end 70 of housing66. The length and inside diameter of image guiding system receptacle 48are selected so that second stem 60 can be received snugly therein. Awindow 72 is provided at the end of the second stem 60 to provide a sealfor the image guiding cable 44. A first approximately cylindrical stem56 extends from one coupling end 70 of housing 66 parallel to secondstem 60. The first stem 56 is smaller in diameter and length than thesecond stem 60. Also window 74 is provided at the end of the first stem56 to provide a seal for the light guiding cable 46.

[0052] Second stem 60, comprises a cylindrical segment 76, and annulargroove 78, and a terminal conical segment 80. Both stems 56 and 60extend in a coupling direction to mate with receptacles 52 and 48respectively.

[0053] A locking element 82, displaceable radially with respect to thecoupling direction, is located in housing 50. Locking element 82 may beapproximately the shape of a two-tined fork that is bent inward in acircular shape at the outer end, the radius of curvature correspondingapproximately to the radius of curvature of image guiding systemreceptacle 48. The outer ends of locking element 82 project slightlyinto image guiding system receptacle 48 as shown in FIG. 5.

[0054] Conical segment 80 of second stem 60 thereby encounters the endsof locking element 82 projecting into image guiding system receptacle 48and displaces them radially outward.

[0055] When second stem 60 has been pushed into image guiding systemreceptacle 48 to the point that the ends of locking element 82 come torest at the level of annular groove 78, they snap into annular groove78.

[0056] In this position the coupling is now closed, i.e. coupling system10 is coupled and mechanically interlocked. In this state, window 72 ofsecond stem 60 and window 84 in the base of image guiding systemreceptacle 48 lie congruently with one another, thus creating animage-guiding coupling. Window 74 of first stem 56 comes to rest infront of window 86 of light guiding system receptacle 52, so that alight-guiding coupling is also created.

[0057] All that is necessary to release the coupling is withdraw thelight and image guiding attachment outward with enough force to overcomethe locking element 82 as engaged in annular groove 78.

[0058] It is now seen that joining the blade 12 and the light and imageguiding attachment 14 to the handle 16 is a swift process. The portionsof the hinge-type joinder 20 are engaged and the handle 16 is thenrotated, locking the blade 12 into place. To attach the light and imageguiding attachment 14 one fits the distal end 43 of the light and imageguiding attachment 14 through the attachment hole 42 at the distal end36 of the blade 12 and then engages stems 56 and 60 of the couplingelement 64 with receptacles 52 and 48 in a coupling direction. Removalis quick—merely withdraw the light and image guiding attachment 14 androtate the handle 16 to release the blade 12, and pull the handle 16away from the blade 12. Removal and replacement are very simple.

[0059] Having a detachably connectable light and image guidingattachment 14 means that the light and image guiding attachment 14 maybe detached from the handle 16 for sterilization. This further meansthat the handle 16 must no longer be hermetically sealed forsterilization. This provides the distinct advantage of lowering the costinvolved with manufacturing the handle 16 as now they do not have to besubjected to the extremely high temperatures associated with thesterilization process. Further, any electronic components located in thehandle 16 will no longer be subjected to the high temperatures ofsterilization, which could prematurely age or damage them.

[0060] Instead of the camera and illumination arrangements alreadydescribed, there are other alternatives, which can be used in anycombination.

[0061] For example, instead of employing a separate light source (notshown), a battery and light bulb may be contained in the handle 16, andthe light from this bulb focused onto light guiding cable 46. Thiseliminates the need for a fiber optic bundle from a light source, andalso eliminates the separate light source itself.

[0062] The video laryngoscope 10, along with the attached blade 110 andlight and image guiding attachment 112 is illustrated in FIG. 7. Thevideo laryngoscope 10 is again comprised of three main parts; the blade110, the light and image guiding attachment 112, and the handle 16.

[0063] The blade 12 illustrated in FIGS. 1 and 2 is a curved blade 12,which is used to elevate the patients tongue in some circumstances. Itis the well-known McIntosh blade 12. However, a different blade 110 fora different anatomical configuration is a straight blade 110 adapted foruse in other circumstances. It is illustrated in FIG. 7. This is thewell-known Foregger-Magill blade 110. These are the two most commonblade shapes. Their configuration is not a limitation on the invention.The configurations of this handle 16 and these blades are completelyconventional. They are standard equipment utilized by anesthesiologiststrained to intubate the trachea. An advantage of this invention is thatit does not require any additional training or re-training ofanesthesiologists who have used these well known blades and willutilized them in the future.

[0064] The curved blade 12 illustrated in FIGS. 1 and 2 differs from thestraight blade 110 illustrated in FIG. 7 only by its shape. The straightblade 110 in FIG. 7 has a straight upper surface 114 instead of a curvedsurface 40 for use when such a surface is preferred for lifting thetongue of the individual patient. In all cases the objective is to liftthe tongue to permit visualization of the vocal cords and to enable theendotracheal tube to be accurately placed without harming surroundingtissue in the process.

[0065] In addition, the light and image guiding attachment 116 as shownin FIG. 7, differs from the light and image guiding attachment 14 asdepicted in FIGS. 1 and 4 only by its shape. The light and image guidingattachment 14 is curved to match the curved blade 12 as depicted inFIGS. 1 and 4, whereas the light and image guiding attachment 116 is astraighter configuration corresponding to the straight blade 110 asshown in FIG. 7.

[0066] As the handle 16, the blade 110 and the light and image guidingattachment 112 operate in the same manner as the aforedescribed curvedblade 12 and light and image guiding attachment 14, they will not bere-described.

[0067] Although the invention has been described with reference to aparticular arrangement of parts, features and the like, these are notintended to exhaust all possible arrangements or features, and indeedmany other modifications and variations will be ascertainable to thoseof skill in the art.

What is claimed is:
 1. An intubating laryngoscope system comprising: ablade; a handle including: a joinder for detachably connecting saidhandle to said blade; a two-stem receptacle connector; a first lightguide for transmitting illuminating light and terminated in the two-stemreceptacle connector; an first image guide for transmitting reflectedlight and terminated in the two-stem receptacle connector; and a lightand image guiding attachment, detachably connectable to said handle, thelight and image guiding attachment including: a two-stem plug connectordesigned to mate with the two-stem receptacle connector; a second lightguide for transmitting illuminating light and terminated in the two-stemplug connector; a second image guide for transmitting reflected lightand terminated in the two-stem plug connector; and a substantially rigidouter casing for encasing the second light guide and the second imageguide; wherein said first light guide and said first image guide are incommunication with said second light guide and said second image guiderespectively, via the receptacle and plug connectors when in an engagedposition.
 2. The system according to claim 1 wherein said two-stem plugconnector comprises a first stem and a second stem, the second stembeing larger in diameter and length than the first stem.
 3. The systemaccording to claim 2 wherein said two-stem receptacle connector and saidtwo-stem plug connector comprise a locking element to rigidly maintainthe connectors together when in an engaged position.
 4. The systemaccording to claim 3 wherein said locking element is displaceabletransversely to a direction of movement to engage the connectors, saidlocking element being engagable into a recess provided on a stem of saidtwo-stem plug connector.
 5. The system according to claim 4 such thatwhen the two-stem receptacle connector with the two-stem plug connectorare engaged there is an audible indication upon engagement.
 6. Thesystem according to claim 2 wherein the second stem has a conical endsection followed by an undercut.
 7. The system according to claim 6wherein the undercut is configured as an annular groove of the secondstem.
 8. The system according to claim 2 wherein the first and secondstems and said two-stem receptacle connector each have windows.
 9. Thesystem according to claim 1 wherein said handle is adapted to receivedan eyepiece.
 10. The system according to claim 1 in which said light andimage guiding attachment comprises stainless steel.
 11. The systemaccording to claim 1 in which said light guiding cable is a fiber opticcable.
 12. The system according to claim 1 in which said light source isa battery and bulb combination in said handle to provide illuminatinglight to said light guiding cable.
 13. The system according to claim 1wherein said light and image guiding attachment further comprises anoptically clear and transparent window for sealing a distal end of saidlight and image guide attachment.
 14. An intubating laryngoscope systemcomprising: a handle having first light guide and a first image guide; ablade; a joinder for detachably connecting said handle to said blade; areceptacle connector, for terminating the first light guide and thefirst image guide; a light and image guiding attachment, detachablyconnectable to said handle, including: a plug connector having a firststem and a second stem; a second light guide terminated in the firststem; a second image guide terminated in the second stem; and asubstantially rigid outer casing for encasing the second light guide andthe second image guide.
 15. The system according to claim 14 whereinsaid receptacle connector and said plug connector comprise a lockingelement to rigidly maintain the connectors together when in an engagedposition.
 16. The system according to claim 15 wherein said lockingelement is displaceable transversely to a direction of movement toengage the connectors, said locking element being engagable into arecess provided on the second stem.
 17. The system according to claim 16such that when the receptacle connector with the plug connector areengaged there is an audible indication upon engagement.
 18. The systemaccording to claim 16 wherein said second stem has a conical end sectionfollowed by an undercut.
 19. The system according to claim 17 whereinthe undercut is configured as an annular groove of the second stem. 20.The system according to claim 14 wherein the second stem and thereceptacle connector receiving it each have an optically cleartransparent window.
 21. The system according to claim 14 wherein saidhandle is adapted to received an eyepiece.
 22. The system according toclaim 14 in which said light and image guiding attachment comprisesstainless steel.
 23. The system according to claim 22 in which saidlight and image guiding attachment is closed at a distal end with anoptically clear and transparent window.
 24. A method for providing anintubating laryngoscope system including the steps of: providing ahandle having a first light guide and a first image guide; providing ablade; providing a receptacle connector located in the handle;terminating the first light guide and the first image guide in thereceptacle connector; providing a rigid light and image attachment thatis detachably connectable to the handle, the light and image attachmenthaving a second light guide and a second image guide located therein;providing a plug connector at a proximal end of the light and imageattachment; terminating the second light guide in the plug connector;terminating the second image guide in the plug connector; detachablyconnecting the blade to the handle; and detachably connecting the lightand image attachment to the handle such that the first light guide andthe first image guide are in communication with the second light guideand the second image guide respectively, via the receptacle and plugconnectors when in an engaged position.
 25. The method of claim 24further comprising the step of providing a locking element for thereceptacle connector and the plug connector and rigidly maintaining themtogether when in an engaged position.
 26. The method of claim 25 furthercomprising the step of providing an audible indication when thereceptacle connector with the plug connector are fully engaged.
 27. Themethod of claim 24 further comprising the step of adapting said handleto receive an eyepiece.
 28. The method of claim 24 wherein said in saidlight and image attachment comprises stainless steel.
 29. The method ofclaim 24 further comprising the step of providing an optically clear andtransparent window at a distal end of the light and image attachment.30. An intubating laryngoscope system comprising: a handle having afirst light guide and a first image guide; a blade connected to saidhandle; a receptacle connector for terminating the first light guide andthe first image guide; and a substantially rigid light and image guidingattachment, detachably connectable to said handle, and including: a plugconnector insertable into said receptacle connector; a second lightguide terminated in the plug connector; a second image guide terminatedin the plug connector; wherein said first light guide and said firstimage guide are in communication with said second light guide and saidsecond image guide respectively, via the receptacle and plug connectorswhen in an engaged position.
 31. A light and image guiding system for anintubating laryngoscope comprising: a two-stem receptacle connector,located in a handle, for terminating a first light guide and a firstimage guide; a two-stem plug connector, located at a proximal end of alight and image guiding attachment, for terminating a second light guideand a second image guide; wherein said two-stem plug connector isreceivable in said two-stem receptacle connector and the first lightguide and the first image guide are in communication with the secondlight guide and the second image guide respectively, via the receptacleand plug connectors when in an engaged position.